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NEWS: The Age - 5/06/2006 'Solving an overdose paradox'

hoptis

hoptis

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Solving an overdose paradox
Harriet Alexander
June 5, 2006

THE mystery of long-term heroin users dying by overdose despite experience with the drug may have been solved by a study linking overdoses with liver disease.

Researchers have puzzled for years about why heroin users defy the laws of experience and mortality that apply to others who practise risky activities and are more likely to survive as they age. Instead heroin overdoses are more likely to occur among people who have used the drug in a similar way for many years than among novice users.

The NSW Drug and Alcohol Research Council investigated 841 deaths due to opioid toxicity and found 10 per cent of those aged 35 to 44 and a quarter of those aged over 44 had been diagnosed with cirrhosis.

This could make them more susceptible to overdose, said Professor Shane Darke from the Drug and Alcohol Research Council at the University of NSW.

"They've got these phenomenally high rates of … liver disease," Dr Darke said. "If they hadn't died of overdose, they would have died of cirrhosis."

A 70 per cent incidence of hepatitis C and a high rate of alcohol consumption may account for the likelihood of liver disease, the study said.

Nearly a quarter of those studied had multiple-organ disease. "They're drinking, they're using heroin frequently, their bodies are just wearing out," Dr Darke said.

In 2004, 357 Australians died of heroin and opioid overdose. Those aged 25-34 comprised the biggest group at 43 per cent, followed by people aged 35 to 44 (28 per cent), 45 to 54 (18 per cent) and 15 to 24 (10 per cent).

Meanwhile, a significant number of injecting drug users are not being tested for hepatitis and other blood-borne diseases despite national public health policies, a survey has found.

Transmission of blood-borne viruses among drug users is still a considerable problem in Australia, with hepatitis B and C still spreading rapidly.

A survey of 222 drug and alcohol services has found that while about 75 per cent offer some testing and vaccinations for these conditions and HIV, fewer then half do so routinely.

The study, published in the Medical Journal of Australia, also found only one-third offer these testing services routinely on site.

With AAP
Click to expand...

From The Age
 
there is a thread in darkside that talks about how environment affects your tolerance...I think its that factor that is the bigger issue to worry about.

I’ve noticed anecdotally (is that right spelling?) its usually outside the usual environment that many of the overdoses my friends (including myself) have experinced over-doses.

In fact I don't think I’ve know anyone to have OD'd in their normal drug using environment.
 
I didn't think this was a big "mystery"...

Even long term users are susceptible to variations in purity, surely?
 
^ the mystery is the typical fatal opiate OD profile - it's NOT inexperienced, younger users who die, it's older experienced ones. This is the opposite of what happens with, say, motorcycle riders (deaths most common amongst younger riders, whereas older riders actually have a better-than-average safety record).

The strongest association with OD fatality is not purity - it's mixing with benzos and/or alcohol. That said - now that average heroin purity in Australia has come down to about 20%, there are a lot less fatal ODs!

There IS some research to show that stress/unfamiliar context increase susceptibility to OD - so good call Chugs.

The Age article implies that there are vaccines available for hep C and HIV - there aren't!!
 
I believe the answer to the amazing mystery is that injecting is very dangerous. And if you do it then make sure its just that 1 single injection, and not continued use.
 
ayjay said:
That said - now that average heroin purity in Australia has come down to about 20%, there are a lot less fatal ODs!
Click to expand...

Unless your in Queensland that is. :)
 
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